“I need health insurance - should I do it myself? Should I use a Navigator? Or should I use an Agent/Broker*??”

Certainly some individuals have taken the Do-It-Yourself route and ‘survived the process’. Others have tried and gotten tangled up in the tax questions, some were led to the wrong website and thought they didn’t qualify for help, some picked the ‘cheapest plan’, only to find out later that it wasn’t their best choice and some picked a plan that didn’t cover the providers and hospitals that they utilized.

As a matter of fact much of the ‘information’ that you get through local media (local newspapers, radio, websites and even the recent political debates) shows that much of the law is misunderstood in one way or another. So, yes, you can D-I-Y, but if you can get the professional services of a licensed professional for free, why wouldn’t you take that option?

As to the Navigator vs. Agent question, both receive some training and are certified to act as guides for a state’s exchange. Both can help you—free of charge—to use the government insurance exchange to enroll in a health plan. They can also help you apply for government subsidies to lower your health insurance costs.

However, the differences are significant.

Health insurance agents and brokers are licensed by a state’s department of insurance. Insurance is their chosen career that they work at every day – to assist customers in finding and purchasing the right insurance to meet their needs. Navigators are frequently volunteers or may work for non-profit organizations and community organizations to assist individuals with insurance related matters only during the once a year open enrollment period.

While licensed agents may have several years of experience assisting customers in understanding their health insurance options, the role of the navigator only began last year. Agents are keenly aware of the impacts to individuals who have picked the wrong plan and work to ensure that doesn’t happen.

Only an agent can recommend a plan based on someone’s health care needs and budget; navigators are trained to help you ‘navigate’ the government website but are prohibited from providing any plan recommendations.

Licensed agents must also pass additional professional examinations at the state and federal level and participate in continuing education programs in order to assist insurance customers before, during, and after enrollment. That ongoing education helps ensure their knowledge in the health insurance field is current. Navigators, on the other hand, don’t have the same education and preparation requirement.

Lastly, agents can work with clients to identify other gaps in coverage such as ways to help cover high deductibles, disability or indemnity coverage to provide income replacement, life insurance, standalone dental plans and more.